I think I may have found a lump in my breast, I am really scared but my family doctor intimidates me – what should I do?
We can understand how scary it can be to find a lump in your breast. But first and foremost, you should have it checked out by a doctor. It might be a cyst, or it might be serious and you should not wait to get it checked out.
Breasts are dynamic organs that change considerably during our lifetime in response to changes in our body's hormone production. Lumps that can be felt in our breasts may be cysts, benign tumours such as fibroadenomas, pseudolumps (clumps of dense glandular tissue and stroma), or cancers.
Cysts are fluid-filled sacs that develop from dilated lobules (milk-producing glands) or ducts. They are almost always harmless, but it is impossible to distinguish between a cyst or a solid breast mass simply feeling it. Cysts can be diagnosed by ultrasound or by removing the fluid and making sure no lump remains. Cysts may be present on and off for several years; often they occur in groups. Simple cysts require no treatment unless they are causing symptoms of pain or are so big that they prevent you from being able to feel the surrounding breast tissue well on exam. The treatment is to numb the overlying skin, insert a small needle into the cyst, and remove the fluid into a syringe (aspiration).
Fibroadenomas are thought to form in women in their teens, 20s and 30s. It results from excess formation of the lobules and stroma (connective tissue of the breast). The lump feels round and smooth, and often "shoots" to a different part of the breast when pushed upon. Fibroadenomas are rarely associated with cancer. Occasionally a fibroadenoma grows large enough to distort the breast's shape. Such fibroadenoma is usually removed surgically.
Pseudolumps are areas of dense glandular tissue and stroma, which are normal breast tissue. Many women who have not yet gone through menopause have occasional pain or overall lumpiness in their breast. These changes are also called fibrocystic changes. Some areas of the breast may become more stimulated or "turned on" by hormones, and may feel like a large lump. It is natural for breast tissue to change in degree of "lumpiness" throughout a woman's hormonal cycle. Because these changes are so common and so little is known about their cause, they are hard to treat and cannot really be cured. To make sure there is no sign of cancer, these areas should be evaluated medically, usually with good breast imaging and follow up exams.
We know how scary seeing a doctor can sometimes be, especially a male doctor. Is there anyone who could go with you to an appointment? Do you have anyone in your life who you could talk to about this, i.e. your mother, an aunt, your grand-mother, a sister? Sometimes talking about it and having someone with you during your appointment can help keep you calm and focused, and give you other kinds of emotional support. Or if you really don't think you can see your doctor, is there a walk-in clinic or other service in you city/town? Most walk-in clinics have female physicians. You can ask that you only see a woman doctor if this is an issue for you.
The Canadian Women's Health Network has gathered a number of resources on breast health and breast cancer. You can access the listings at the following web addresses:
Someone close to me has been diagnosed with breast cancer and I would like to find out more about it. Can you suggest some further references on this topic?
The Canadian Women's Health Network has gathered a wealth of resources on breast cancer. You can access the listing at the following web address:
http://www.cwhn.ca/search/Results.htm?category=Breast%20Cancer
The Canadian Cancer Society can provide you with information on breast cancer, treatment options, medications and clinical trials, controlling treatment effects, alternative therapies and resources that can help. You can reach them toll-free at 1-888-939-3333, or online at http://www.cancer.ca/
The Canadian Breast Cancer Network is the national voice of breast cancer survivors. It links groups and individuals concerned about breast cancer, and represents the concerns of all Canadians affected by breast cancer and those at risk. You can reach them toll-free at 1-888-939-3333 or online http://www.cbcn.ca/
I've heard that breast cancer can be caused by using antiperspirants, which I wear daily. Can you clarify?
You may have received an email that had been circulating claiming that there is a link between the use of antiperspirants and breast cancer in women. This is based upon personal opinion and not scientific fact. There is no proof that antiperspirants are linked to breast cancer in women. The email claims that using an antiperspirant inhibits sweating, preventing the body from eliminating toxins that build up in the lymph nodes in the armpits to the point that cell mutations occur. In actual fact, perspiration is primarily a cooling mechanism and toxins are eliminated from the body mainly by the liver and kidneys. In addition, the email states that most cancerous tumours are found in the upper-outer quadrant of the breast, which is where the lymph notes are located. Only 50% of cancerous tumours are found in this area, yet this area contains the most breast tissue.
The Canadian Cancer Society has an excellent article that debunks this myth, entitled Antiperpirants and breast cancer.
Although the causes of breast cancer are still not known some of the risk factories include:
- being female
- getteing older
- beginning menstruation at an early age
- having a family history of breast cancer.
To maintain breast health, the best approach is early detection through regular examinations – monthly breast self-examinations, yearly clinical breast examination done by a health professional, and annual mammograms after the age of 50.
I would like to have bigger breasts. Are those breast enlargement pills I see advertised in magazines effective? What about breast implants?
Breasts usually begin to develop between the ages of 8 and 13. Sometimes, one breast will start developing before the other or grow more quickly than the other, but the difference evens out once you are full-grown, usually around age 20. Breasts come in all shapes and sizes: large, small, pointed, flat, full, round, hanging or firm. Breast size has nothing to do with what kind of person we are. The inside of each breast consists of fat, connective tissue and a milk-producing (mammary) gland. Most of the breast consists of fat that surrounds the gland. The amount of fat in the breasts is partly determined by heredity. This fat makes breast size vary, and explains why breast size is not related to the sexual responsiveness of the breast or to the amount of milk produced after we have given birth. Because sex hormone levels change during the menstrual cycle, when we start and stop birth control pills, during pregnancy, during lactation, and after menopause, there can be variations in a particular woman's breast size and shape.
While there are many different pills on the market claiming to make breasts bigger, they do not work . No exercise, supplement or diet will change the size or shape of your breasts.
Breast implants are medical devices – flexible synthetic envelopes filled with salt water (saline) or silicone gel. Breast augmentation surgery using implants has risks, but the risks are much greater for some women than others. According to implant makers' patient booklets, implants are not recommended for women with any of the following:
- Active infection anywhere in your body.
- Autoimmune diseases (such as arthritis, lupus and scleroderma). (If family members have these diseases, that can put you at higher risk also)
- Conditions that interfere with wound healing and blood clotting.
- A weakened immune system (such as currently receiving immunosuppressive therapy).
All breast implants, silicone or saline, have high complication rates. Research conducted by implant manufacturers and analyzed by the FDA in the United States finds that most women have at least one serious complication within the first 3 years. Two of the most common are capsular contracture (which causes breast hardness and pain) and the need for additional surgery.
Most women like the way the implants look and feel for the first few years, but after that many find their implants look less natural or start to feel too firm or hard, and can be very painful. If an implant breaks or causes pain, surgery is necessary.
The Canadian Women's Health Network has gathered a number of resources on breast implants. You can access the listing at the following web address:
We believe that being comfortable with your body is really important. If you have any concerns about your breast size, you might want to talk to a friend, a female relative or family member about it, and about what factors are influencing your desire to increase your breast size. You might also want to visit a women's clinic in your areas and talk to a sympathetic doctor about your concerns.
My girlfriend has very large breasts and as a result suffers from backaches, how do we find a doctor to have a breast reduction done?
In order to have a breast reduction done, your family doctor must refer you to a plastic surgeon. If you find you are not happy with your family doctor's reaction, look around for a woman or woman-friendly physician. The costs of breast reduction are sometimes covered by medicare, but the plastic surgeon will be able to answer that question directly.
As with any surgery, breast reduction carries risks, such as infection, reaction to anesthesia, scarring, etc. Some risks also depend on the techniques the plastic surgeon uses, so it is best to make sure you ask about all possible risks when discussing the surgery. If a woman is carrying extra weight, she may be asked to lose some before further consultations can take place. As breasts are mostly made up of body fat, losing weight will make them somewhat smaller. Weight loss will also move the nipples up closer to where they should be, which helps in the surgery.